| NPI | 1710932629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON TODD Office Administrator 910-762-8754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2019-06-05 |